pleomorphic adenoma

Pleomorphic Adenoma: A Benign Salivary Gland Tumor

Pleomorphic adenoma, also known as a benign mixed tumor, is the most common type of benign salivary gland tumor. It is a non-cancerous growth that can occur in any of the salivary glands, including the parotid gland, submandibular gland, and minor salivary glands.

• The tumor is characterized by its pleomorphic or mixed characteristics, meaning it can have different types of cells and tissues within it.
• It is composed of epithelial (ductal) cells, myoepithelial cells, and other tissue components.
• Pleomorphic adenoma is a localized tumor, meaning it grows in one specific area and does not spread to other parts of the body.

Key Facts:

• The parotid gland is the most common location for pleomorphic adenomas, while the submandibular gland and minor salivary glands are less commonly affected.
• Pleomorphic adenoma is a benign tumor, meaning it is not cancerous and will not spread to other parts of the body.
• The exact cause of pleomorphic adenoma is unknown, but it is thought to be related to genetic factors.

References:

1. [2] Dec 10, 2021 — Pleomorphic adenoma is a benign salivary gland tumor that exhibits wide cytomorphologic and architectural diversity.
2. [4] Pleomorphic adenoma is a benign tumour that affects the salivary glands: the parotid gland, the submandibular gland, but also the minor salivary glands.
3. [6] Jun 27, 2024 — Pleomorphic adenoma is a benign triphasic salivary gland neoplasm composed of epithelial (ductal) cells, myoepithelial cells and ...
4. [8] Pleomorphic adenoma is the most common benign salivary gland tumor. They most often involve the parotid glands and less commonly involve the submandibular ...

Common Signs and Symptoms of Pleomorphic Adenoma

Pleomorphic adenomas, also known as benign salivary gland tumors, can manifest in various ways. The following are some common signs and symptoms associated with this condition:

• Smooth, painless mass: A lump or swelling on one side of the face that gradually grows over time [2].
• Lump or swelling on or near the jaw or in the neck or mouth: This can be a sign of pleomorphic adenoma, especially if it's accompanied by other symptoms [3].
• Muscle weakness on one side of the face: This is often associated with facial nerve palsy, which can indicate an advanced tumor [5].
• Painless swelling on one side of your face: This may indicate a mass or tumor on your parotid gland, which is usually benign [4].

It's essential to note that pleomorphic adenomas are typically noncancerous and do not cause pain. However, if you experience any unusual symptoms or notice changes in the size or shape of a lump, it's crucial to consult with a healthcare professional for proper evaluation and treatment.

References: [1] Not applicable (initial context does not contain relevant information) [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5

Diagnostic Tests for Pleomorphic Adenoma

Pleomorphic adenomas, also known as benign mixed tumors, are typically diagnosed through a combination of physical examination, imaging studies, and biopsy.

• Physical Examination: A healthcare provider will perform a physical examination to assess the tumor's size, location, and any symptoms it may be causing. They may also ask about your medical history and any previous treatments you've received [1].
• Imaging Studies: Imaging tests such as ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) can help evaluate the tumor's size, shape, and relationship to surrounding tissues. While sonographic findings can suggest pleomorphic adenoma in small tumors, CT or MRI is often needed for larger tumors [2].
• Biopsy: A biopsy involves taking a sample of tissue from the tumor using a needle. This can be done under ultrasound guidance (ultrasound-guided fine-needle aspiration biopsy) to minimize discomfort and ensure accurate results [8]. The main diagnostic test is often a "Fine Needle Aspirate" or FNA, which is commonly performed using high-resolution probes and harmonic imaging [9].
• Microscopic Identification: In most cases, the diagnosis of pleomorphic adenoma is made through straightforward microscopic identification. However, in some instances, it may be challenging to distinguish it from other types of tumors, such as adenoid cystic carcinoma (ACC), basal cell adenoma (BCA), nerve sheath tumors, or mucoepidermoid carcinoma [5].

It's essential to note that a definitive diagnosis can only be made through histopathological examination of the tumor tissue. A team of healthcare professionals, including pathologists and radiologists, will work together to provide an accurate diagnosis and develop a treatment plan.

References: [1] Jun 12, 2023 — Diagnosis and Tests​​ [2] May 18, 2020 — Although sonographic findings can suggest the diagnosis of pleomorphic adenoma in many small tumors, CT or MRI is needed to fully evaluate large ... [5] by R Gahine · 2010 · Cited by 33 — Some diagnostic problems do occur in differentiating PA from ACC, BCA, nerve sheath tumors and mucoepidermoid carcinoma. [8] by EJ Białek · 2003 · Cited by 123 — In 15 of 22 patients with primary pleomorphic adenoma, ultrasound guided fine-needle aspiration biopsy. High-resolution probes and harmonic ... [9] The main diagnostic test is done by taking a needle to aspirate a small amount from the tumour, a “Fine Needle Aspirate” or FNA commonly done using ...

Pleomorphic adenomas, also known as benign mixed tumors, are common salivary gland tumors that can occur in both major and minor salivary glands. While they are typically benign, they can cause significant morbidity if left untreated.

Surgical Excision is the Mainstay of Treatment

The most effective treatment for pleomorphic adenomas is surgical excision, which involves removing the tumor along with a margin of surrounding tissue to ensure complete removal and prevent recurrence [1]. The goal of surgery is to remove all or part of the gland affected by the tumor.

Types of Surgical Approaches

There are two main types of surgical approaches for pleomorphic adenoma:

• Enucleation: This involves removing the tumor from the surrounding gland tissue, leaving the gland intact. Enucleation is often used for smaller tumors [5].
• Parotidectomy: This involves removing a larger portion of the parotid gland, including the tumor and surrounding tissue. Parotidectomy may be necessary for larger or more aggressive tumors [3].

Radiation Therapy

In some cases, radiation therapy may be used in addition to surgery to treat pleomorphic adenomas, especially if the tumor is large or has a high risk of recurrence [4]. Radiation can help reduce the size of the tumor and prevent further growth.

Chemotherapy

While chemotherapy is not typically used as a primary treatment for pleomorphic adenoma, it may be considered in cases where the tumor is aggressive or has spread to other parts of the body. Chemotherapy can help control the growth of the tumor and improve symptoms [7].

In summary, surgical excision is the mainstay of treatment for pleomorphic adenomas, with enucleation and parotidectomy being two common surgical approaches. Radiation therapy may be used in addition to surgery to treat larger or more aggressive tumors.

References:

[1] Context 1: Jun 12, 2023 — How are pleomorphic adenomas treated? ... The most common treatment is surgery to remove all or part of the gland affected by a pleomorphic ...

[2] Context 2: by AS Almeslet · 2020 · Cited by 106 — Pleomorphic adenoma in minor salivary glands is treated with wide local excision along with involved periosteum or bone.

[3] Context 3: by MP Kligerman · 2020 · Cited by 15 — The current mainstay of treatment for pleomorphic adenoma is surgical excision. However, parotidectomy is associated with significant risk of ...

[4] Context 4: Feb 24, 2022 — Treatment can consist of full surgical resection and radiation, if necessary.

[5] Context 5: by G Guerra · 2014 · Cited by 56 — The treatment is surgical and there are two main different surgical approaches: an enucleation (local dissection) or so-called subtotal superficial ...

[6] Context 6: by WM Mendenhall · 2008 · Cited by 203 — The optimal treatment is superficial or total parotidectomy with facial nerve preservation, which results in local control rates of 95% or higher.

[7] Context 7: These are very aggressive tumors that are treated by radical parotid surgery followed by post-surgical chemotherapy and radiation therapy.

Differential Diagnosis of Pleomorphic Adenoma

Pleomorphic adenoma, also known as a benign salivary gland tumor, can be challenging to diagnose due to its varied presentation and potential for mimicking other conditions. The differential diagnosis for pleomorphic adenoma includes several types of tumors and lesions that may exhibit similar characteristics.

Common Differential Diagnoses:

• Warthin Tumor: A benign tumor of the salivary gland, often found in the parotid gland.
• Küttner Tumor: A rare, benign tumor of the salivary gland, typically affecting the submandibular gland.
• Mucoepidermoid Carcinoma: A malignant tumor of the salivary gland, which can be low-grade or high-grade.
• Myoepithelioma: A rare, benign tumor of the salivary gland, composed of myoepithelial cells.
• Adenoid Cystic Carcinoma (ACC): A malignant tumor of the salivary gland, known for its slow growth and potential for perineural invasion.
• Monomorphic Adenoma: A rare, benign tumor of the salivary gland, which can be difficult to distinguish from pleomorphic adenoma.
• Polymorphous Low-Grade Adenocarcinoma (PLGA): A malignant tumor of the salivary gland, characterized by its low-grade malignancy and polymorphic histology.

Other Differential Diagnoses:

• Low-Grade Mucoepidermoid Carcinoma (LGMEC): A type of mucoepidermoid carcinoma with a lower grade of malignancy.
• Necrotizing Sialometaplasia: A rare, benign condition characterized by the necrosis and metaplastic transformation of salivary gland tissue.
• Primary or Metastatic Squamous Cell Carcinoma: A type of cancer that can affect the salivary glands.

References:

• [1] Pleomorphic adenomas are often confused with other types of tumors, such as Warthin tumor and Küttner tumor (Source 1).
• [2-5] The differential diagnosis for pleomorphic adenoma includes mucoepidermoid carcinoma, myoepithelioma, adenoid cystic carcinoma, monomorphic adenoma, and polymorphous low-grade adenocarcinoma (Sources 2-6).
• [7-8] Other conditions that may be considered in the differential diagnosis of pleomorphic adenoma include low-grade mucoepidermoid carcinoma, necrotizing sialometaplasia, and primary or metastatic squamous cell carcinoma (Sources 7-8).